Peds Head Trauma
Dr. Rich LaVeau
Feasibility and Accuracy of Fast MRI Versus CT for Traumatic Brain Injury in Young Children.
This study was a single site prospective cohort study that attempted fast MRI in pediatric patients under 6 years old who had head CT performed. Feasibility was assessed by completion rate and imaging time. Fast MRI accuracy was measured against CT findings of TBI, including skull fracture, intracranial hemorrhage, or parenchymal injury.
299 patients qualified, MRI was attempted in 225, and completed in 223. Mean imaging time was 59 seconds for CT and 365 seconds for fast MRI. TBI identified in 111 of these patients on CT. Fast MRI identified TBI in 103 of these patients (sensitivity 92.8; 95% CI), notably missing 2 subarachnoid hemorrhages and 6 isolated linear non-depressed skull fractures. However, fast MRI identified 6 TBIs in 5 patients missed on CT: 3 subdurals, 2 parenchymal contusions, and 1 subarachnoid hemorrhage
All fast MRIs were done without sedation and time to complete was ~6 mins versus 59 seconds for CT
PECARN should be standard of care and utilized appropriately